The number of Palestinians killed in a 19-day-old Israeli offensive in the Gaza Strip reached at least 1,000 on Wednesday, including hundreds of civilians, officials in the Hamas-run Health Ministry in the enclave said.

The figures, in common with previous counts, are subject to the difficulties of counting and verification in the chaos of the war. Israeli officials have given no firm casualty toll for Palestinians but say troops have killed hundreds of militants.

At least 10 people, including at least four militants, were killed on Wednesday, medics said. Bodies were also retrieved from past attacks. It took the total death toll to 1,010, said Muawiyah Hassanein, head of the ministry’s ambulance service.

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The Gaza-based Palestinian Center for Human Rights said it had compiled figures showing 673 civilians had died since Israel launched its air campaign on Dec. 27. These included 225 children and 69 women. Earlier this week, the health ministry said about 400 women and children were among the dead.